title: Biological and clinical correlates after chemotherapy and granulocyte colony-stimulating factor administration.
abstract: OBJECTIVE
  To evaluate specific biological markers to improve understanding and use of granulocyte colony-stimulating factor (G-CSF) in patients receiving chemotherapy
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  University-affiliated hospital and cancer center.
  
  
  METHODS
  Twenty-five patients randomized to begin G-CSF either 24 hours after chemotherapy (standard arm), or on the day the absolute neutrophil count (ANC) was below 1000/mm3 after chemotherapy (delayed arm).
  
  
  METHODS
  To determine the effect of G-CSF on granulopoiesis, peripheral blood mononuclear cells were assayed by semisolid culture medium and flow cytometry for granulocyte progenitors and clonogenic CD34 antigen-positive cells. These biological markers were correlated with G-CSF administration schedules and the ANC.
  
  
  RESULTS
  The effect of timing of G-CSF administration on rate of neutrophil recovery, duration of neutropenia, length of G-CSF therapy, delays of chemotherapy cycles, and neutropenic fever events was evaluated. Regardless of G-CSF schedule or chemotherapy regimen, the appearance of mobilized hematopoietic progenitors begins at the neutrophil nadir and parallels granulocyte recovery. Our data also demonstrate that proper timing of G-CSF administration produces similar rates of neutrophil recovery and comparable clinical outcomes.
  
  
  CONCLUSIONS
  Based on the correlation between biological markers and ANC, we propose that the postchemotherapy ANC is a surrogate marker of renewed granulopoietic activity. The relevance of this finding in relationship to the clinical application of G-CSF remains to be further defined.
authors.affiliation: Department of Pharmacy Practice, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Higa
authors.forename: R F
authors.initials: RF
authors.lastname: DeVore
authors.forename: M L
authors.initials: ML
authors.lastname: Auber
authors.forename: J P
authors.initials: JP
authors.lastname: Lynch
authors.forename: K S
authors.initials: KS
authors.lastname: Landreth
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000097:blood*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy*; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D009504:Neutrophils; D011446:Prospective Studies
chemical_list: D018952:Antigens, CD34; D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor